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35.2 week baby born + trouble establishing milk supply

We had a worrisome last pregnancy weeks, baby had oligohidramnios which was being monitored closely by ultra sonograms, doing better at first, but in the last visit, it dropped to nothing, baby has already starting to feel this, so the doctor decided on an immediate c-section; mother had steroid dose for pulmonary maturing at around 32 weeks. Born well the 10th of February, no suffering, no meconium, Capurro baby age: 37 weeks. Apgar 8/9. No need for oxygen, incubator, anything. Unfortunately, we were unable to start the first-hour breast feeding due to the surgery, and delayed it around 12 hours. At first, he seemed to do ok, but now he seems to be crying for more all the time, and pediatricians told us to use formula if needed. But mother has nipple wounds and it hurts, and use of pump takes one or two drops the most. We are very worried that milk has stopped, and wounds are not encouraging. How long till we say that the milk is over definitely, because we wanna keep trying!! As long as the breast allows us to. Mother using a lanoline lotion, father thinks Vaseline could work better. Any suggestions? You can tell we are first-timers thank you all!!

Re: 35.2 week baby born + trouble establishing milk supply

Congrats on the new baby!

It's very normal for newborns to seem to cry for more all the time -their tummies are extremely tiny, and breastmilk digests quite quickly. Is the baby able to latch? If so, I would put the baby to the breast rather than use the pump. Has your milk come in yet? It's not uncommon for it to take a little longer after a c-section. There's only a small amount of colostrum (that's all baby needs at first), so it's not surprising that pumping isn't yielding much. If your wife can stand the discomfort, I would opt for just putting the baby to breast as often as she can, and avoid the formula. Breast stimulation is the only way to get the milk to come in. Watch the diapers carefully. By day 5, I think you're supposed to have at least 5 wet diapers and 3 dirty ones or so.

Can you describe these nipple wounds? are they actually sores, or are the nipples just painful? Is there a lactation consultant that you could see to help you determine if it's a latch issue, and to help you fix it? You can find one here http://www.iblce.org/home
If they are wounds, you can ask for a script for Dr. Newman's all-purpose nipple ointment, which is very helpful. http://www.nbci.ca/index.php?option=...tion&Itemid=17 and there are some great videos on this site for proper latch, etc.

Re: 35.2 week baby born + trouble establishing milk supply

Thanks for your quick reply!! The wounds are small fissures inside the nipple, they don't get to the areola. Hurt a lot, look like they could bleed if they keep going forward. Someone told us that maybe the humidity is causing them, so well try to keep them dry, see if it gets better. We know a special lactation consultant, works with the baby's paediatrician. So we'll try that person probably. We'll keep you updated if it gets better (or worse, hope not the last). Thank you!!

Re: 35.2 week baby born + trouble establishing milk supply

Are the wounds slit-like, the sorts of cracks or near-cracks you'd see with extremely dry skin? Also, is mom experiencing any of he following:
- itching or burning sensations, particularly AFTER nursing or pumping?
- dry, flaking skin in the nipple or areola?
- vaginal yeast infection?
- nipples appearing more red, pink, or shiny than normal?
And is the baby having any of the following:
- oral thrush?
- yeast diaper rash?

There is NO point at which milk is "over." Milk supply can be increased at any time by increasing frequency and duration of stimulation to the breast. This is why adoptive mothers- including those who have never been pregnant or nursed a baby!- can breastfeed, and why women can regain a full milk supply even after a prolonged period of not nursing.

Re: 35.2 week baby born + trouble establishing milk supply

Thank you again! Yes, wounds are slit like and leave a little bit of bruising-like coloration after a day. No itching-burning-or any other infection signs, doesn't seem to be the case. No oral thrush in the baby either. It looks like it could be the skin getting used to the new "living-style". Is this a possibility? And there is also a very big psicological factor. We are both easily stressed, and we know this could also be a factor affecting milk production. So we are trying to be patient and keeping hope up Thank you, this replies are helping too. Any other tips? We are reading a lot in the forums previous threads and articles. We'll keep on fighting.

Re: 35.2 week baby born + trouble establishing milk supply

Is seeing a lactation consultant, preferably an IBCLC, a possibility? And would it be possible to go back and see the doctor? Slit-like cracks are a red flag to me that something infectious could be a problem. Cracks from a poor latch tend to be large, single wounds, rather than small slits.